| Square One Dental Llc | |
|
3510 Rowe Lane Cumming GA 30041 | |
| (770) 888-8295 | |
| Not Available |
| Full Name | Square One Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3510 Rowe Lane, Cumming, Georgia |
| Authorized Official Name and Position | Sengsouriya Ananthasane (DENTIST) |
| Authorized Official Contact | 7708888295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Square One Dental Llc 5870 Charlotte Ln Suite 200 Cumming GA 30040-0316 Ph: (770) 888-8295 | Square One Dental Llc 3510 Rowe Lane Cumming GA 30041 Ph: (770) 888-8295 |
| NPI Number | 1679029219 |
|---|---|
| Provider Enumeration Date | 09/01/2016 |
| Last Update Date | 09/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679029219 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN012307 (Georgia) | Primary |
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